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首页> 外文期刊>Angiologia e Cirurgia Vascular >Cost-effectiveness of the endovascular repair: of Abdominal Aortic Aneurysm in Portugal
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Cost-effectiveness of the endovascular repair: of Abdominal Aortic Aneurysm in Portugal

机译：血管内修复的成本效益：葡萄牙的腹主动脉瘤

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Endovascular Aneurysm Repair (EVAR) for the treatment of aortic abdominal aneurism has been shown to improve short-term survival and quality of life as compared to Open Repair (OR), while reducing the rate of serious complications and allowing for the treatment of more patients. Objectives: To examine the cost-effectiveness of EVAR compared to OR in the treatment of aortic abdominal aneurism in the Portuguese context using a model previously developed in the UK. Methodology: We adapted an international economic evaluation model to the Portuguese situation, assuming that the health benefits of EVAR observed in clinical trials would also apply to Portuguese patients. We carried out an expert panel survey to calculate the resource use associated with the intervention and its short and long-term consequences, valued with Portuguese prices. Results: The major cost difference in the primary intervention (difference of 3,064 ? in favor of OR) is related to the cost of the endograft/graft. No major differences are observed in the total cost of complications and re-interventions between the two procedures. EVAR represents a cost of 16,709 ? over lifetime compared to 12,130 ? for OR. Using data from the literature we show that EVAR allows for 0.17 additional undiscounted years of life and 0.091 additional undiscounted quality-adjusted life years. The incremental cost-effectiveness ratio (ICER) of EVAR is of 65,605 ?/QALY. Conclusion: Endovascular repair of aortic abdominal aneurysm represents an effective alternative and has been used increasingly in Portugal and elsewhere. Our study shows that its cost-effectiveness is currently above the commonly accepted threshold in Portugal, but that the economic value of EVAR would greatly improve if benefits were confirmed in the long run after the intervention. Under these circumstances, EVAR would become an economically valuable intervention that could be adopted on a large scale in Portugal.
机译：与开放式修复（OR）相比，用于主动脉腹部动脉瘤的血管内动脉瘤修复（EVAR）已显示可改善短期生存率和生活质量，同时降低严重并发症的发生率并允许治疗更多患者。目的：使用先前在英国开发的模型，探讨在葡萄牙背景下，EVAR与OR相比在主动脉腹部动脉瘤治疗中的成本效益。方法：我们假设葡萄牙EVAR的健康益处也将适用于葡萄牙患者，因此我们根据葡萄牙的情况调整了国际经济评估模型。我们进行了一次专家小组调查，以计算与干预有关的资源利用及其短期和长期后果，并以葡萄牙价格计算。结果：主要干预措施的主要成本差异（赞成者为3,064？）与内移植物/移植物的成本有关。两种方法在并发症和再干预的总费用上没有发现主要差异。 EVAR表示成本为16709？寿命超过12130？或。使用来自文献的数据，我们表明EVAR可以增加0.17个额外的未折算寿命，并增加0.091个未折算的质量调整寿命。 EVAR的增量成本效益比（ICER）为65605？/ QALY。结论：主动脉腹部动脉瘤的血管内修复是一种有效的替代方法，在葡萄牙和其他地区已得到越来越多的使用。我们的研究表明，其成本效益目前已超过葡萄牙公认的门槛，但如果从干预后的长期角度确认收益，EVAR的经济价值将大大提高。在这种情况下，EVAR将成为具有经济价值的干预措施，可以在葡萄牙大规模采用。

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